scholarly journals Combined Office-based Vergence Therapy and Home Therapy System for Convergence Insufficiency in Egyptian Children

2018 ◽  
Vol 12 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Tarek Nehad ◽  
Tamer Salem ◽  
Mohamed Nagy Elmohamady

Background: Convergence Insufficiency (CI) is a common binocular vision disorder characterized by exophoria more at near than at far, a receded Near Point of Convergence (NPC), and decreased Positive Fusional Vergence (PFV) at near. This disorder is often associated with several symptoms that may disturb the person’s quality of life. Therefore, diagnosis and treatment of CI is a vital issue. Objectives: To compare therapeutic yield of Office Based Vision Therapy (OBVT) and combined OBVT with Home Therapy System (HTS) in patients with CI. Methods: The study included 102 patients with age range of 7-13 years. All patients underwent Convergence Insufficiency Symptom Survey (CISS) scoring, estimation of Near Point of Convergence (NPC) and determination of Positive Fusional Vergence at near (PFV) using Sheard’s criterion. Patients were randomly allocated in two groups: Group I: received Office-based Vision Therapy (OBVT) and Group II: received OBVT with home reinforcement using the Home Therapy System (HTS). At the end of 12th week of therapy; outcome was determined as Successful (all the following: CISS score of <16, NPC <6 cm and PFV >15Δ), Improved (CISS score of <16 or a 10 points-decrease and one of the following: NPC <6cm or improved by >4 cm, PFV >15Δ or increased by > 10Δ), Insufficient response (NPC <6cm or improved by >4 cm, PFV >15Δ or increased by > 10Δ) and non-responders. Results: At the end of the 12th week of therapy, the applied therapeutic polices were successful in 48 patients (47.1%), the symptoms were improved in 30 patients (29.4%), improvement was insufficient in 13 patients (12.7%) and 11 patients (10.8%) were considered as non-responders. There was significantly higher frequency of patients with improved outcome in group II (86%) compared to group I (69.2%). Conclusion: OBVT with home supplement using HTS provided a high success rate, and it seems to be superior to OBVT alone in treatment of children with convergence insufficiency after 12-week course of therapy.

Genetics ◽  
1996 ◽  
Vol 142 (1) ◽  
pp. 295-303 ◽  
Author(s):  
Jianzhi Zhang ◽  
Masatoshi Nei

Antennapedia (Antp)-class homeobox genes are involved in the determination of pattern formation along the anterior-posterior axis of the animal embryo. A phylogenetic analysis of Antp-class homeodomains of the nematode, Drosophila, amphioxus, mouse, and human indicates that the 13 cognate group genes of this gene family can be divided into two major groups, i.e., groups I and II. Group I genes can further be divided into subgroups A (cognate groups 1–2), B (cognate group 3), and C (cognate groups 4–8), and group II genes can be divided into subgroups D (cognate groups 9–10) and E (cognate groups 11–13), though this classification is somewhat ambiguous. Evolutionary distances among different amino acid sequences suggest that the divergence between group I and group II genes occurred ∼1000 million years (MY) ago, and the five different subgroups were formed by ∼600 MY ago, probably before the divergence of Pseudocoelomates (e.g., nematodes) and Coelomates (e.g., insects and chordates). Our results show that the genes that are phylogenetically close are also closely located in the chromosome, suggesting that the colinearity between the gene expression and gene arrangement was generated by successive tandem gene duplications and that the gene arrangement has been maintained by some sort of selection.


2016 ◽  
Vol 33 (S1) ◽  
pp. S362-S362 ◽  
Author(s):  
E. Zaky ◽  
M. Rashad ◽  
H. Elsafoury ◽  
E. Ismail

BackgroundThe role of psychological factors in the development and maintenance of encopresis is controversial.ObjectivesAssessment of the psychosocial profile of encopretic children and their caregivers in relation to parenting style compared to controls.MethodologyThe current cross sectional study comprised 90 Egyptian children classified into three groups: group I (encopresis without constipation and overflow incontinence), group II (encopresis with constipation and overflow incontinence), and group III (clinically healthy controls); each group included 30 children. Thorough clinical evaluation and psychometric assessment were carried out for all enrolled children while caregivers were evaluated for their parenting styles, anxiety, depression, and introversion scores.ResultsHardness, undue blaming, and indecisive parenting styles were significantly more prevalent among caregivers of group I. Encopretic children of group I & II had poorer self-esteem and higher prevalence of clinically manifest depression compared to healthy controls. Furthermore, there was a higher prevalence of clinically manifest paternal anxiety, depression, and introversion and maternal depression among caregivers of group II and higher prevalence of clinically manifest paternal anxiety and depression among fathers of group I.ConclusionThe approach of toilet training, not the time of its initiation, seems to be the factor that really matters in predisposing to and perpetuating encopresis. Further exploration is needed to determine if the documented association of psychological disorders of enrolled encopretic children and their caregivers was causal or being just the impact of the child's encopresis.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2019 ◽  
Vol 36 (1) ◽  
pp. 14-20
Author(s):  
Dmitriy G. Amarantov ◽  
Mikhail F. Zarivchatsky ◽  
Andrey A. Kholodar ◽  
Andrey S. Nagaev ◽  
Oleg S. Gudkov

Aim. To improve the results of treatment in patients with thoracoabdominal injuries (TAI) by means of creating the method of determining indications for the use of classical or endoscopic surgeries in respect of this pathology. Materials and methods. Seventy-six sufferers from TAI were divided into 2 groups. Results. The method of successive determination of indications for the use of classical or endoscopic surgeries in patients with TAI was created on the basis of treatment of 41 (53.95 %) patients of group II. This method was used to treat 35 (46.05 %) patients of group I. Conclusions. Rational approach to the choice between the use of advantages of classical and endoscopic surgeries depending on characteristics of clinical situation permitted to elevate the quality of treatment in patients with TAI.


2019 ◽  
Vol 46 (2) ◽  
pp. 32-37
Author(s):  
Dilshad Parvin ◽  
Md Nasir Uddin ◽  
Md Shahjahn Kabir ◽  
Afsana Ahmed ◽  
SM Rahat Hossain ◽  
...  

Acute coronary syndrome (ACS), a life-threatening manifestation of coronary artery disease, ranges from unstable angina (UA) to acute myocardial infarction (AMI). To reduce the morbidity and mortality resulting from acute coronary syndrome, we should have to find out some predictor or prognostic indicator. A prognostic indicator should be available at the time of initial patient’s evaluation, in order to maximize the potential benefits of early risk assessment. This study designed to evaluate plasma BNP as a prognostic tool in patients with acute coronary syndrome. A prognostic cohort study was carried out with 90 (ninety) acute coronary syndrome patients on the basis of their clinical and laboratory criteria with age range of 30 to 90 years in the department of biochemistry, BSMMU, in collaboration with department of cardiology, NICVD, BSMMU and BIRDEM. Plasma BNP concentrations were measured on enrollment and then grouping of the study subjects were done on the basis of their empirical cut off value of plasma BNP concentration. All the patients were free from heart failure, renal disease, thyroid disease and hepatic disorder. Main outcomes were mortality, morbidity and survival after hospital discharge with or without any disability. All the subjects were categorized into two and to see the significance between two groups in relation to age and sex Unpaired –t test and Chi square test were done. Finally, Binary logistic regression was done. Among 90 acute coronary syndromes patients, there were 74(82.2%) male and 16(17.8%) female with mean age of the study population 51.8 years and the age range of 30 t0 90 years. Among enrolled patients, 24 (26.7%) were NSTEMI and 66 (73.3%) were STEMI that includes 29 (32.2%) anterior MI, 21 (23.3%) inferior MI, 16 (17.8%) other varieties of MI. All the study subjects were grouped into two on the basis of empirical cut off value of plasma BNP 640pg/ml on enrollment. Group I with plasma BNP level less than 640pg/ml includes 57 (63.3%) subjects and group II with plasma BNP more than 640pg/ml includes 33 (36.7%) subjects. Among group I (n=57) good recovery, morbidity and mortality found to be in 41(71.9%), 15(26.3%) and 1(1.8%) patients and those in group II (n=33) found in 6(18.2%), 19(57.6%) and 8(24.2%) patients respectively. Keeping the group I in reference category binary logistic regression analysis done, showing odds ratio 11.5 with p- value 0.000. The odds ratio 11.5 indicates that there is 11.5 times higher chance of getting bad outcome in ACS patients having higher plasma BNP concentrations. Bangladesh Med J. 2017 May; 46 (2): 32-37


2013 ◽  
Vol 25 (2) ◽  
pp. 50-58 ◽  
Author(s):  
Parveen Shahida Akhtar ◽  
M Md Shakhawat Hossain ◽  
Zafor Md Masud ◽  
Naheed Ruksana ◽  
Shamsun Nahar ◽  
...  

Background: Cervical cancer is the most common cancer of Bangladeshi women diagnosed mostly (>80%) at stage II and stage III. Rdaiotherapy (both teletherapy and brachytherapy) is the most important modality of treatment at these stages.Objective: To compare the local control, diseases free survival and overall survival between the (cancer cervix) patients treated randomly by two schedules of radiotherapy. Method: From June 1996 to June 2005, patients with histologically confirmed carcinoma cervix (Ca.cervix) were treated by external beam therapy (EBRT) as well as intra cavitery brachytherapy (ICRT) along with concurrent/sequential chemotherapy with cisplatin and 5- Fluorouracil. EBRT was given by cobalt60 teletherapy machine and ICRT by caesium137 low dose rate machine. The patients were divided into two groups according to treatment schedules. Group I: the patients in this group received EBRT in whole pelvis in two steps, first with open field upto 10-20 Gy then by applying midline shield with lead block 30-40Gy in 25-28 total fractions, five days a week; they also received 50-70 Gy to point A by ICRT in 2-4 weekly fractions. Group II: patients in this group received with open field a dose of 45-50Gy in 25-28 fractions, 5 days a week by EBRT and 25-30 Gy at point A by ICRT in 1-2 weekly fractions.Result: In Group I, 96 out of 101 and in Group II, 104 out of 118 patients were eligible for evaluation. In both groups patients were distributed according to stages and age more or less equally; their age range were 30-70 years and mean age was 47.2 years in Group I and age range were 25-80 years and mean age was 46 years in Group II. Squamous cell carcinoma were found (90%) and performance status was WHO grade 0-1 (>75%) in both groups. Local control of disease at 5 years was 65% in group I and 51% in group II. Overall survival at 2 years, 5 years, 7 years and 9 years in group I, was 71%, 64%, 55%, 46% and in group II, 54%,50%, 43%,32% respectively. Distant metastasis occurred in 22% in-group I and 28% in-group II. Lymph node, lung, liver, peritoneum were common site of metastasis. Proctitis, cystitis, vaginal stenosis in group I was 80%, 33% 16% and in Group II 29%, 13% and 5% respectively. Conclusion: External beam therapy and brachytherapy was effective treatment in carcinoma. Cervix in both operable and inoperable stages. In small volume of tumor, both schedules of radiotherapy were more or less equivalent but in bulky diseases Group I schedule that was higher dose by brachytherapy at point A showed better result; though the complication was more DOI: http://dx.doi.org/10.3329/bjog.v25i2.13739 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 50-58


2009 ◽  
Vol 76 (3) ◽  
pp. 203-206 ◽  
Author(s):  
G. Minaldi ◽  
B. Ventimiglia ◽  
M. Finocchiaro ◽  
I. Fanzone ◽  
A. Tsirgiotis ◽  
...  

Urinary incontinence during sexual intercourse refers to overactive bladder (OAB) syndrome and it is divided in incontinence during penetration and during orgasm. 480 women with low urinary tract symptoms (LUTS) were divided in a) affected by probable genuine stress incontinence, b) probable Urge-stress incontinence, c) probable Urge Incontinence, to specify incidence. Materials and Methods In Group C (186 women) 36 women, age range 24 to 56 years, with urinary incontinence only during sexual intercourse, were selected: 16 during orgasm (group I), 20 during penetration (group II). These patients filled in specific validated questionnaires (ICI-9), urinary recordings and, after urine exam, they underwent US study of urinary tract with post-micturition evaluation. The patients with other urological diseases or pelvic prolapse in stage II of POP-Q or higher were excluded. Patients were referred to physiatric evaluation and urodynamic exam with cystomanometry and perineal EMG, with provocative tests and after pressure-flow study. Results Cystocele was found in 4 out of 16 women in Group I, and in 6 out of 20 in Group II. No patients showed basic detrusor hyperactivity during cystomanometry. In Group I: 50% had detrusor hyperactivity and 18.75% had prolonged perineal relaxation. In Group II 30% had detrusor hyperactivity and 35% had prolonged perineal deficit. Results suggest parasympathetic deficiency in Group I and sympathetic deficiency in Group II.


2018 ◽  
Vol 5 (10) ◽  
pp. 3391
Author(s):  
Akhilesh Kumar Yadav ◽  
Sankalp Dwivedi ◽  
Siddharth Desai

Background: The study was done to compare outcomes with dressings of honey to povidone iodine in the management of diabetic foot ulcers.Methods: The present study was carried out for a period of three years from June 2016 to July 2018 in a medical college of northern India. About 200 patients who presented with features of diabetic foot were selected randomly and included in this study and divided into two groups based upon the subsequent treatment of raw area with honey and povidone- iodine respectively.Results: A total of 200 patients were studied. Group I consist of 100 patients out of which 58 were males and 42 females while in Group II there were 56 males and 44 females. The age range in group I was 46 to 75 years while the age range in group II was 48 to 82 years.  In case of group I time of healing was 7- 75 days with median of 28 while in group II time of healing was 7- 60 days with median of 18 days. In case of group II time of healing was 7-60 days with median of 18 days, hospital stay was 7- 34 days with median of 12 days.Conclusions: In terms of hospital stay, time of healing, allergy to material and need for amputation honey was found to be better than povidone iodine solution for dressing of diabetic foot ulcers.


2020 ◽  
pp. 51-56
Author(s):  
T.G. Romanenko ◽  
◽  
O.V. Morozova ◽  
O.M. Sulimenko ◽  
◽  
...  

The objective: to reduce the frequency and severity of iron deficiency anemia (IDA) in multiple pregnancies by optimizing its prevention, treatment and proving the effectiveness and safety of the therapy. Materials and methods. 90 pregnant women were under observation. The control group (CG) consisted of 30 pregnant women with one fetus, group I – 30 women with multiple pregnancies who did not use the recommended therapy, group II – 30 women with multiple pregnancies, conducted according to our proposed method. The effectiveness of therapy was evaluated weekly by subjective evaluation of improvement and according to laboratory parameters of peripheral blood. General clinical methods included clinical, general blood analysis and determination of serum iron, quantitative determination of the concentration of sulfhydryl groups and lipoproteins in erythrocyte elements of peripheral blood, studied the surface architecture of erythrocyte membranes. Results. There was a significant reduction in the frequency and severity of IDA in pregnant women of group II in 1.6 times.Diagnosed with a significant increase in the number of discocytes (group I 67.340.81; group II 84.531.04; p<0.05), a decrease in the number of ellipses (group I 0.990.05; group II 0.600.05; p<0.05); flat disks (group I 0.870.07; group II 0.560.03; p<0.05); dome-shaped (I group 2.410.14; ІІ group 1.820,11; р<0.05) and spherical erythrocytes (І group 4.110.12; ІІ group 2.440, 13; p<0.05). Significant decrease in the number of transitional forms (group I 3.410.31%; group II 2.530.21; p<0.05); pre hemolytic (I group 2.410.14%; ІІ group 1.440.11%; р<0.05) and degenerative forms (І group 1.180.14%; ІІ group 0.520.03; p<0.05), as well as the ratio of the inner and outer diameters of erythrocytes (group I 66.710.91; group II 45.810.63; p<0.05). There was a significant increase in the ratio of sulfhydryl groups and lipoproteins in erythrocyte membranes. Conclusions. The complex composition of the drug Fersinol and Fersinol-Z, taking into account the effective antianemic action, can be considered optimal for the prevention and treatment of iron deficiency in multiple pregnancies and recommended for use in practical health care. Keywords: multiple pregnancy, iron deficiency anemia, prevention, treatment, Fersinol ampoules, Fersinol-Z capsules.


1992 ◽  
Vol 76 (6) ◽  
pp. 1029-1031 ◽  
Author(s):  
Edward C. Benzel ◽  
Jay P. Mashburn ◽  
Steven Conrad ◽  
Denise Modling

✓ The absence of spontaneous respirations at a PaCO2 of 60 mm Hg or above has traditionally been accepted as the respiratory criteria for the determination of brain death. The testing of patients for the presence or absence of apnea has been complicated because the rate of PaCO2 elevation may vary substantially from patient to patient, and a nonlinear relationship exists between the rate of PaCO2 increase and the duration of apnea. In an attempt to refine the apnea test and to further elucidate the physiology of hypercapnia in humans, 11 patients who met all but the respiratory criteria for brain death were evaluated using a modification of a previously utilized apnea testing protocol. All patients were brought to a PaCO2 of 40 mm Hg or above prior to the apnea test. Baseline PaCO2 ranged from 40 to 45 mm Hg in six patients (Group I) and from 46 to 51 mm Hg in five patients (Group II). The mean rate of PaCO2 increase was 5.1 ± 1.4 mm Hg/min in Group I and 6.7 ± 3.1 mm Hg/min in Group II. No problems with cardiovascular instability or hypoxia were encountered during testing in this series. This refinement of the apnea test allows for a streamlined and safe approach to brain death detection.


1966 ◽  
Vol 38 (1) ◽  
pp. 59-63
Author(s):  
K. Roine ◽  
T. Varvikko ◽  
L. Lappalainen ◽  
K. Östring

Fourteen sexually mature heads of cattle were divided into two groups; Group I receiving mineral mixture A, containing 15 % of Bolus alba, while Group II were given mixture B, containing no Bolus alba, but 10 % more Ca. Otherwise, both groups received the same feeding. Samples of blood and faeces of the animals were taken monthly for the determination of phosphorus, respectively phosphorus and carotenes. The experiment lasted one stabling period. In Group I, the mean inorganic phosphorus values of the blood were 6.7 mg/100 ml. and in Group 11, 6.1 mg/100 ml. The mean phosphorus values of the faeces were 8.8 gr/kg dry matter in Group I and in Group II, 9.3 gr/kg dry matter. The mean carotene values in Group I were 98.3 mg/kg dry matter and in Group II, 96.3 mg/kg dry matter. However, none of these differencies is statistically significant. On the basis of the present investigation it can be concluded that Bolus alba exerts no detrimental influence on the resorption of phosphorus and carotenes in the digestive tract of cattle.


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